Anatomic distribution and pathologic characterization of small-volume prostate cancer (< 0.5 ml) in whole-mount prostatectomy specimens

Liang Cheng, Timothy D. Jones, Chong Xian Pan, Ayana Barbarin, John Eble, Michael Koch

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Some investigators consider small-volume prostate cancer (0.5 ml or less) without Gleason pattern 4/5 elements as clinically insignificant. The objective of this study was to characterize the anatomic distribution and pathologic features of small tumors (aggregate volume of 0.5 ml or less) in whole-mount prostatectomy specimens. Between 1999 and 2003, 371 consecutive patients underwent radical prostatectomy at the Indiana University Hospitals for localized prostate cancer. Patients who received hormonal or radiation therapy prior to the surgery were excluded from the study. A total of 62 specimens with total tumor volume of 0.5 ml or less were identified and included in this study. All specimens were embedded and whole-mounted. Tumor volume was measured using the grid method. The mean age at the time of surgery was 59 years (median, 61 years; range, 37-72 years). The mean preoperative prostate-specific antigen (PSA) was 6.5 ng/ml (range: 0.3-18 ng/ml). The mean prostate weight was 53 g (range: 16-132 g). The mean tumor volume was 0.29 ml (median, 0.35ml; range, 0.02-0.48 ml). Tumor multifocality and bilaterality were present in 69 and 37% of cases, respectively. Three (5%) had positive surgical margins. The largest tumor was located in the peripheral zone, transitional zone, and central zone in 79, 16, and 5% of cases, respectively. The largest tumor was located in the anterior prostate in 10 cases (16%) and in the posterior prostate in 52 cases (84%). The distribution of Gleason scores was 5 (12 cases, 19%), 6 (40 cases, 65%), and 7 (10 cases, 16%). One case had a primary Gleason pattern 4. None had extraprostatic extension, seminal vesicle invasion, or lymph node metastasis. Small-volume prostate cancers are often multifocal and bilateral, with predilection for the peripheral zone. Of these small-volume cases, 16% had Gleason pattern 4 and might, therefore, be clinically significant.

Original languageEnglish
Pages (from-to)1022-1026
Number of pages5
JournalModern Pathology
Volume18
Issue number8
DOIs
StatePublished - Aug 2005

Fingerprint

Prostatectomy
Tumor Burden
Prostatic Neoplasms
Prostate
Neoplasms
Neoplasm Grading
Seminal Vesicles
Prostate-Specific Antigen
Radiotherapy
Lymph Nodes
Research Personnel
Neoplasm Metastasis
Weights and Measures

Keywords

  • Insignificant prostate cancer
  • Neoplasm
  • Prostate
  • Prostatectomy
  • Small tumor volume
  • Tumor staging

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Anatomic distribution and pathologic characterization of small-volume prostate cancer (< 0.5 ml) in whole-mount prostatectomy specimens. / Cheng, Liang; Jones, Timothy D.; Pan, Chong Xian; Barbarin, Ayana; Eble, John; Koch, Michael.

In: Modern Pathology, Vol. 18, No. 8, 08.2005, p. 1022-1026.

Research output: Contribution to journalArticle

@article{b07187d590a54eb18d6607d743866525,
title = "Anatomic distribution and pathologic characterization of small-volume prostate cancer (< 0.5 ml) in whole-mount prostatectomy specimens",
abstract = "Some investigators consider small-volume prostate cancer (0.5 ml or less) without Gleason pattern 4/5 elements as clinically insignificant. The objective of this study was to characterize the anatomic distribution and pathologic features of small tumors (aggregate volume of 0.5 ml or less) in whole-mount prostatectomy specimens. Between 1999 and 2003, 371 consecutive patients underwent radical prostatectomy at the Indiana University Hospitals for localized prostate cancer. Patients who received hormonal or radiation therapy prior to the surgery were excluded from the study. A total of 62 specimens with total tumor volume of 0.5 ml or less were identified and included in this study. All specimens were embedded and whole-mounted. Tumor volume was measured using the grid method. The mean age at the time of surgery was 59 years (median, 61 years; range, 37-72 years). The mean preoperative prostate-specific antigen (PSA) was 6.5 ng/ml (range: 0.3-18 ng/ml). The mean prostate weight was 53 g (range: 16-132 g). The mean tumor volume was 0.29 ml (median, 0.35ml; range, 0.02-0.48 ml). Tumor multifocality and bilaterality were present in 69 and 37{\%} of cases, respectively. Three (5{\%}) had positive surgical margins. The largest tumor was located in the peripheral zone, transitional zone, and central zone in 79, 16, and 5{\%} of cases, respectively. The largest tumor was located in the anterior prostate in 10 cases (16{\%}) and in the posterior prostate in 52 cases (84{\%}). The distribution of Gleason scores was 5 (12 cases, 19{\%}), 6 (40 cases, 65{\%}), and 7 (10 cases, 16{\%}). One case had a primary Gleason pattern 4. None had extraprostatic extension, seminal vesicle invasion, or lymph node metastasis. Small-volume prostate cancers are often multifocal and bilateral, with predilection for the peripheral zone. Of these small-volume cases, 16{\%} had Gleason pattern 4 and might, therefore, be clinically significant.",
keywords = "Insignificant prostate cancer, Neoplasm, Prostate, Prostatectomy, Small tumor volume, Tumor staging",
author = "Liang Cheng and Jones, {Timothy D.} and Pan, {Chong Xian} and Ayana Barbarin and John Eble and Michael Koch",
year = "2005",
month = "8",
doi = "10.1038/modpathol.3800431",
language = "English",
volume = "18",
pages = "1022--1026",
journal = "Modern Pathology",
issn = "0893-3952",
publisher = "Nature Publishing Group",
number = "8",

}

TY - JOUR

T1 - Anatomic distribution and pathologic characterization of small-volume prostate cancer (< 0.5 ml) in whole-mount prostatectomy specimens

AU - Cheng, Liang

AU - Jones, Timothy D.

AU - Pan, Chong Xian

AU - Barbarin, Ayana

AU - Eble, John

AU - Koch, Michael

PY - 2005/8

Y1 - 2005/8

N2 - Some investigators consider small-volume prostate cancer (0.5 ml or less) without Gleason pattern 4/5 elements as clinically insignificant. The objective of this study was to characterize the anatomic distribution and pathologic features of small tumors (aggregate volume of 0.5 ml or less) in whole-mount prostatectomy specimens. Between 1999 and 2003, 371 consecutive patients underwent radical prostatectomy at the Indiana University Hospitals for localized prostate cancer. Patients who received hormonal or radiation therapy prior to the surgery were excluded from the study. A total of 62 specimens with total tumor volume of 0.5 ml or less were identified and included in this study. All specimens were embedded and whole-mounted. Tumor volume was measured using the grid method. The mean age at the time of surgery was 59 years (median, 61 years; range, 37-72 years). The mean preoperative prostate-specific antigen (PSA) was 6.5 ng/ml (range: 0.3-18 ng/ml). The mean prostate weight was 53 g (range: 16-132 g). The mean tumor volume was 0.29 ml (median, 0.35ml; range, 0.02-0.48 ml). Tumor multifocality and bilaterality were present in 69 and 37% of cases, respectively. Three (5%) had positive surgical margins. The largest tumor was located in the peripheral zone, transitional zone, and central zone in 79, 16, and 5% of cases, respectively. The largest tumor was located in the anterior prostate in 10 cases (16%) and in the posterior prostate in 52 cases (84%). The distribution of Gleason scores was 5 (12 cases, 19%), 6 (40 cases, 65%), and 7 (10 cases, 16%). One case had a primary Gleason pattern 4. None had extraprostatic extension, seminal vesicle invasion, or lymph node metastasis. Small-volume prostate cancers are often multifocal and bilateral, with predilection for the peripheral zone. Of these small-volume cases, 16% had Gleason pattern 4 and might, therefore, be clinically significant.

AB - Some investigators consider small-volume prostate cancer (0.5 ml or less) without Gleason pattern 4/5 elements as clinically insignificant. The objective of this study was to characterize the anatomic distribution and pathologic features of small tumors (aggregate volume of 0.5 ml or less) in whole-mount prostatectomy specimens. Between 1999 and 2003, 371 consecutive patients underwent radical prostatectomy at the Indiana University Hospitals for localized prostate cancer. Patients who received hormonal or radiation therapy prior to the surgery were excluded from the study. A total of 62 specimens with total tumor volume of 0.5 ml or less were identified and included in this study. All specimens were embedded and whole-mounted. Tumor volume was measured using the grid method. The mean age at the time of surgery was 59 years (median, 61 years; range, 37-72 years). The mean preoperative prostate-specific antigen (PSA) was 6.5 ng/ml (range: 0.3-18 ng/ml). The mean prostate weight was 53 g (range: 16-132 g). The mean tumor volume was 0.29 ml (median, 0.35ml; range, 0.02-0.48 ml). Tumor multifocality and bilaterality were present in 69 and 37% of cases, respectively. Three (5%) had positive surgical margins. The largest tumor was located in the peripheral zone, transitional zone, and central zone in 79, 16, and 5% of cases, respectively. The largest tumor was located in the anterior prostate in 10 cases (16%) and in the posterior prostate in 52 cases (84%). The distribution of Gleason scores was 5 (12 cases, 19%), 6 (40 cases, 65%), and 7 (10 cases, 16%). One case had a primary Gleason pattern 4. None had extraprostatic extension, seminal vesicle invasion, or lymph node metastasis. Small-volume prostate cancers are often multifocal and bilateral, with predilection for the peripheral zone. Of these small-volume cases, 16% had Gleason pattern 4 and might, therefore, be clinically significant.

KW - Insignificant prostate cancer

KW - Neoplasm

KW - Prostate

KW - Prostatectomy

KW - Small tumor volume

KW - Tumor staging

UR - http://www.scopus.com/inward/record.url?scp=24044474369&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24044474369&partnerID=8YFLogxK

U2 - 10.1038/modpathol.3800431

DO - 10.1038/modpathol.3800431

M3 - Article

VL - 18

SP - 1022

EP - 1026

JO - Modern Pathology

JF - Modern Pathology

SN - 0893-3952

IS - 8

ER -